Lymphedema (Swelling of the Arms)

Lymphedema is a condition that may affect people who have undergone certain kinds of cancer treatment and can be a serious side effect after breast cancer surgery and radiation therapy. Lymphedema from breast cancer occurs when fluid collects in the chest, under the arm, in the arm or in the hand. Since the fluid cannot drain efficiently, swelling occurs. Lymphedema may occur right after treatment or months to a few years later.

 

Factors that may increase your risk for having lymphedema:

  • Having surgery to remove breast cancer, especially if lymph nodes are removed.
  • Radiation treatment.
  • Being overweight or inactive.
  • Eating a poor diet.
  • Having diabetes.
  • Having a heart problem or any condition that affects the circulatory system.
  • Having had other surgery, trauma or blood clot in the past.

 

Things you can DO to help reduce your risk for lymphedema:

  • Use sunscreen (SPF 30) and insect repellant (with no alcohol in it).
  • Avoid harsh soaps (Dove is a good brand to use) and use low pH creams (less than 5.0 pH, such as Medline Remedy Cream, Aquaphor, Eucerin) to avoid dry, cracking skin and prevent infection.
  • Avoid too much heat, sauna, sunburns, or tans on the affected side.
  • Use an electric razor to avoid cutting the skin under the arm. If using a razor blade, change the blade between each use.
  • Wear gloves to protect your hands while gardening, cooking, grilling, cleaning, or playing with pets.
  • Avoid excessive strain during exercise; use moderation with all exercise.
  • Keep your hand and arm clean and free of cuts. If you get a cut or scrape, clean the area and apply antibacterial cream, like Polysporin.
  • Be cautious to prevent bruising or other blunt trauma.

 

Things you should NOT DO to help reduce your risk for lymphedema:

  • Never have blood drawn or blood pressure checked on the affected side.
  • Do not smoke because tobacco effects tissue repair.
  • Do not lift heavy objects like grocery bags and suitcases on the affected side, including purses that should be carried on the opposite shoulder.
  • Do not get deep tissue massage to the affected arm / chest.
  • Do not get manicures that cut the skin around the nails.
  • Do not wear clothes or jewelry that are tight or binding on your arm, armpit or wrists. Remove all jewelry before going to sleep.
  • Do not ignore any swelling or small minor injuries to the affected arm. Call the doctor right away!

 

If you experience any swelling or pain, talk to your doctor:

  • Report any signs of infection such as redness, warmth, red streaks, pain, or soreness in your affected arm that starts suddenly.
  • Report any changes in the size of your arm or hand.
    • The arm feels full or heavy.
    • Tight feeling skin.
    • Clothes or jewelry fit tighter than usual.
    • Not able to move the hand or arm like usual.

 

How to manage your lymphedema:

  • Elevate the arm as often as you can with support.
  • Try arm and shoulder exercises such as finger and hand squeezes, arm swings, front raises, side raises, and shoulder shrugs. Gentle stretching exercises may also help keep the arm and shoulder movable and prevent pain. These Forge videos show exercises you can do at home.
  • See a therapist trained in manual lymph drainage.
  • Wear a compression bandage or sleeve during the day. A compression bandage or sleeve can either be ready made or custom fitted. You will need a prescription from your doctor and proper fitting / measurements from a trained clinician.
  • Prevent further injury or infection to the arm or hand.
  • Avoid temperature extremes to prevent overloading the lymph system. This includes avoiding extreme cold or hot, including ice packs or hot packs, saunas / hot tubs, fire pits and steam from the oven or grill while cooking.
  • Eat a healthy, balanced diet with low fat, low sodium and high fiber. Avoid alcohol and caffeine and drink plenty of water daily.
  • Wear a “Medical Alert” Bracelet noting your lymphedema.

 

Tips for managing lymphedema when traveling:

  • Wear a compression garment or bandages when flying as the pressure change can cause lymphedema to worsen.
  • Maintain a low salt diet for meals and snacks.
  • Drink plenty of water.
  • Move around frequently and perform exercises while in a car or plane.

This information is shared by Forge partner and certified lymphedema therapist Beth Chandler, who is a physical therapist at Grandview Medical Center and specializes in the treatment of lymphedema.

If you have any questions or concerns, please contact Forge’s Client Services Coordinator, Janet Dees, at (205) 990-5367 or [email protected].

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